RickInOz

Back to references rather than literal titles again. Credit to Blur this time.

Milestones come in all forms, the easiest to acknowledge are numerical ones. A few days ago I made my retrieval “ton”. It didn’t seem so long ago that I was doing my first few and it all seemed very exciting. Now, after over a year of doing these jobs, I realise that a great deal are very run-of-the-mill. The novelty has definitely worn off and I’m after the more thrilling stuff. Unfortunately the nature of the job isn’t like that and I’m going to have tolerate the boring jobs while waiting for the juicy ones to come along.

If nothing else, doing the boring jobs restricts jaunting round the state. I’ve been to Modbury rather too many times and there are still lots of towns out in the country I’ve not been to yet. Hopefully if I keep doing this job long enough, I’ll eventually see them all …. and that will be another milestone!

Not quite a Schrodinger’s Cat analogy, but the way we view something does alter our description of that thing. Any assessment has to based on an accepted norm but also what we become used to. So, in a manner of speaking, in thinking about an aspect of life, we have to challenge our perception.

This sounds all rather cryptic but it was prompted by a page on the BBC news website about the English summer:

“The Met Office has predicted that around the country daytime temperatures could reach 29-30C, with minimum night-time temperatures of 15-18C.”

For the UK, these are unseasonably warm temperatures, and the website bills this as a “heatwave”.

In Adelaide these temperatures would be considered a pleasant spring or autumn day. By comparison, last February, we had 15 consecutive days with peak daytime temperature was greater than 37 degrees, and for at least 4 it was over 45 degrees. The highest minimum one night was 30 degrees. Now that is a heatwave.

Or is it? In some parts of the middle-east or northern Africa, it almost certainly gets hotter than that.

So it’s interesting that it all seems to depend on “the eye of the beholder”.

I seem to be missing something. The rampant hysteria surrounding Michael Jackson’s death is leaving me somewhat cold. Anyone would think that Diana had died again such is the intensity of emotional outpouring. True, he was a great musician and wrote some seminal songs, but plenty of other more worthy musical icons haven’t received such idolatry.

Of course people are free to engage in acts of grief if they like, but the media have jumped lock-stock on the bandwagon. Not too long ago, many media outlets delighted in picking over the train-wreck that Jackson’s life had become. Schadenfreude doesn’t even begin to describe the enthusiastic mudslinging. Now the volte-face is transparently insincere, with those same agencies now engaging in shameless acts of hero worship.

For shame.

Both metaphorically and literally.

Over the past month or so, I have been in a bit of a slump at work. Many of the jobs we do are interesting both in terms of clinical and logistical aspects. It also has seen us travel to some diverse parts of the state. Unfortunately this has not been the case lately and, while my caseload has stayed high, I have been stuck with a lot of what we call “milk runs”. This refers to a job that is unchallenging clinically, sees us go somewhere uninteresting (like a metro hospital) and not have to do any interventions. While they get us out of the building, and are better than sitting around, they offer no satisfaction.

The last couple of the days have seen a change in fortune, one of the fickle aspects of retrieval medicine. I have had to handle a few difficult airway cases and today got to fly to the roadside again. These cases are always rather unfortunate as some poor sod has to be badly injured for us to get our “good” mission. Today’s was no exception with another motorcyclist dying in an accident at Yundi, and us having to transport his battered and bruised mate to the Flinders Medical Centre. It is a strange dichotomy, that in order for us to have interesting and challenging work, some unfortunate person has to be severely unwell or badly injured.

Just to cover the title and tagline. In amongst the tragedy of death and destruction, we noticed that the recent rains have greened the Fleurieu Peninsula to resemble the rolling Leicester countryside we left to come here. Always trying to see some good even in the worst of situations.

Not quite on the scale of the Inaugural Presidential speech, but still fairly daunting.

Today it was the turn of MedSTAR to present to the weekly Retrieval community teleconference. There are a number of organisations similar to ours around Australia including CareFlight and Adult Retrievals Victoria. Since these services are based primarily in state capitals, and are few in number, the great Australian phenomenon of “The Tyranny of Distance“. This makes it difficult to get the small number of specialist together in any one place at the same time.

Fortunately technology comes to the rescue and we conduct shared teaching sessions remotely. The slant of these sessions is to discuss or impart issues that are specific to retrieval medicine, and the unique clinical, technical and logistical considerations. Along with 3 of my colleagues, we presented case reports as a springboard for deeper discussion. Our topics included “Chest Drains“, “Rationale for Retrieval“, “To intubate or not to intubate” and “Stay’n'Play vs Load’n'Go“.

Like many of my colleagues, I have presented to many meetings and teaching sessions, but always thus far to people in the same room. It was a strange experience not being able to see the majority of the audience. Even stranger then to have questions fired at you from a phone rather than being able to see your challenger. Overall I think our subject matter and points for discussion went down well and it certainly generated a fair amount of debate.

So this will be yet another thing to put on my CV – presentation to a multi-agency, interstate aeromedical education forum. For relatively little effort, this sounds fairly impressive. Every little helps.

I’m sure many of you will have noticed the shortage of posts recently. Unfortunately I have no excuse for the reduction in activity, other than that mind is on other things.

We now hear relatively little from the UK, and if not for friends and family, it would almost be as if we had not lived there. One organisation that hasn’t forgotten about me is the General Medical Council. It would be nice to think they care about their registered physicians, but instead it was just the annual demand for cash.

One novel policy of theirs is to introduce licensing in parallel to registration. I’m not entirely sure what the licence is supposed to add, as the old system worked just fine. Previously, doctors could chose to be fully registered (which entitled them to practise), be suspended (sort of still registered, but not actively practicing) or rescind their registration. Now the options are to be licenced and registered (so practise medicine), be registered but not licenced (and not practise) or, again, rescind both licence and registration. So where is the difference? I’m sure some bureaucrat in Westminster is very proud of themselves, but it all seems like unnecessary paperwork for nothing.

However this cloud does have a silver lining; a financial one. For the past couple of years, I have had to pay the top whack in order to keep my registration, despite not doing a day of work in the UK. Now I have the opportunity to remain on the register, but at a vastly reduced rate. Bonus … literally!

Welcome to the 11th review I’ve written on BodyPump by Les Mills International, and the first of the 70s series. Instructors in Europe and elsewhere may already have recieved DVDs, but launches won’t be for a few weeks yet, so the following is for participants. Forewarned is forearmed!

Warmup:
A gentle introduction into the release this time round. There’s nothing special here, and the chore is almost a perfect facsimile of release 69. Regardless, it gets the job done and we’re ready for the working tracks. Music: Don’t Leave me with the Light On – Danzel

Squats:
This is a fairly easy track by comparison to some of the recent releases. The chore is very similar to 69, with the bottom-half pulses recurring. However it is shorter at only 4 rounds, and there is only 1 set of bottom-halves after the second round. Pink contributes music for the second squat track in a row, however I didn’t find It’s All Your Fault as motivating as the Let’s Get This Party Started remix.

Chest:
This is where the release starts to get interesting. The new innovation for this track is a 4:4 slow range with a 2-count hold at the top. The key difference here, is that the hold is at 7/8ths of range rather than right at the top. This means you hold the bar under tension between the slow ranges which causes significant loading and accelerates fatigue. It is a good strategy and prevents people from taking too many rests. Otherwise the track contains just singles and bottom halves, so it is an unusual combination of very slow and very quick reps with little pace in between. This may sound complicated but the chore follows the music well: Infinity 2008 – Guru Josh Project

Back:
Nothing special this time round. The track is rather a spitting image of 67’s back track even down to the use of E-Type again with True Believer. It’s 4 standard rounds with a break after rounds 2 and 3. Perhaps Glen has been taking note of recent criticism as there are far fewer rows so this becomes less a test of forearm strength than previous releases. The pace of the track may seem quick, and there could be a tendency to rush the C&Ps but the pace is actually deceptively slow and there is more time to complete the reps than you might think.

Triceps:
Time to ditch the bar for another track with just free weights (as we last saw with 68). We get alternating tricep press-ups and kickbacks to start with. There are plenty of push-ups this time with varying paces, but no singles, so time under tension is the key again. To finish there is a short set of overhead extension singles. I didn’t find this track especially challenging so there is potential to review weights carried and ensure that technique is spot-on. Music: Keeps Gettin’ Better – Christine Aguilera.

Biceps:
This is a short sharp shock of a track clocking in at only a little over 4 minutes. But don’t be deceived as it is not easy. There are 3 (almost) duplicate rounds with a break between rounds 2 and 3. This release we get both full-range and bottom-half singles as an added challenge, and I was certainly feeling it by the end of the last set. With an added pause in the final round, there is no reason why you shouldn’t be able to keep the same weight on as usual and enjoy that burn. Music: Gotta Be Somebody – Nickelback.

Lunges:
Now for the sting in the release. This track is an excellent example of the KISS approach. There may not be anything innovative, with this track comprising just static lunges and squats, but it certainly delivers a tough workout. We get 4 rounds with the lunges preceding squats for each half of the track. The rep type is fairly standard fare too with almost every pace combination represented. I found this quite tough mainly due to the sheer number of lunges, and noticed it most in my calves during the squats each time. The challenge is to do the squats properly with an effective ROM rather than just using it as active recovery. Music is a blast from the past with Raindrops – Stunt which samples Encore Une Fois by Sash! which controversially sampled Insomnia by Faithless.

Shoulders:
Another tough track, and one of the harder shoulder tracks we’ve had for a while. This is mostly due to us having to stick with lateral raises for 2/3rds of the track before moving onto bar work, so the deltoids become rapidly and progressively fatigued. This track also sees a welcome return for the Mac Raises as an additional challenge. The final round of upright rows and overhead presses finishes off the track nicely. We get Thunderstruck again (also seen in releases 49 [thanks gepl] and 22) but this time it is a cover by Hinder, rather than the AC-DC original.

Abs:
More innovation here, and a number of moves we’ve not done before. We start with a twisting leg extension – hips and knees at 90°, then twist to the side, the straighten the knees while keeping the hips flexed at 90°. This really works the oblique muscles hard and while you won’t feel the first few, this rep is repeated and starts to pull by the end. The next new move is a top-of-jackknife move. Bring your legs up so hips are flexed to 90° but knees are straight. Then, hold a weight up with straight arms and crunch up so that the weight moves towards your ankles. This again sounds easy, but becomes progressively more difficult with repetition. As if this wasn’t enough, we get some hovers as a final round. The twisting hover is back, but rather than keeping your hips static and just moving the upper body, this time we have to pivot seamlessly and quickly from a front- to side-hover. It is more difficult than it sounds and I found it put too much strain through my shoulders. A safer option would be to just twist the upper body as we did in 67, or alternatively hold a static side-hover. Overall, a tough track and a welcome return to form after some of the recent rather easy tracks from the 60s. Music: Love Lockdown – Kanye West.

Warm-down:
Again, nothing unusual here and we stretch out starting with legs before moving to the upper body. The music – If I Were A Boy – Beyonce – was unremarkable so this will not go down as one of the all-time greats.

Overall Impressions:
I liked this release and it is a nice balance of hard and easy tracks. I found the intensity increased sequentially as the release went on, with some of the early tracks (esp Squats) being a little soft. The lunges especially was a perfect example of getting back to basics to achieve a better workout than some of the recent experimental lunge tracks we’ve had.

I thought Shoulders was the weaker link in the release. Sure, it is challenging, but the isolation of deltoid work with rather too many lateral raises, wound up fatiguing some muscle segments while leaving others barely used. Perhaps a set of press-ups would have balanced out the track more. With these fatigued shoulders, I certainly felt it during the hover portion of Abs, and I have concerns that putting bodyweight through this joint in a twisting motion carries too high a risk of injury.

The music mix is certainly going to offer something for all and should please most. Hopefully in future releases we can leave E-Type behind and use some other artists, as their Back tracks are starting to get somewhat tedious both in terms of choreography and sound.

I’ll be interested to hear other people’s opinions on the new moves and whether you agree on which tracks are the more challenging. Over to you!

Unless you have been living in a cave on Mars, with your eyes shut and your fingers in your ears, going “la, la la”, you will be aware that I have been preparing for the JFICM exam later this year. The date is fast approaching and I have little time left to decide whether to commit or not.

Despite fears of being ill-prepared and those gaps in knowledge, I have decided to go ahead. So “the die” is well and truly “cast” and there is no going back. Especially since I had to pony up $3000 for the privilege of sitting this exam. Not wanting this money to go to waste I will obviously give it my all.

It would be nice to think that the pass is assured, but I am being realistic and recognising that failure is always a possibility. Especially since one of my colleagues recently flunked, and he was someone we expected to sail through easily. I have my “Plan B” prepared, but hope not to use it. This is definitely one of those situations where luck only has so much to do with it, and hard work is the only reasonable option.

So, I guess that means I’d better get back to the books!

And an excuse for a reference.

I forgot to add an important element to that last post on cycling in winter, so to provide resolution, here is the rest of it:

One other added protection that many bikers seem to favour is the leg warmer. These have little in common with the 80s fashion disaster, and are instead, tight-fitting leggings as shown here:

Now I would have bought a set to keep my pins warm when it gets really cold, however I have been put off for life.

One of the guys who goes to my gym, and does BodyPump on a Saturday morning too, has recently started wearing lycra leggings. Now this might now sound too bad, but there are a couple of unpleasant aspects. The first is that he has a bit of a pot belly and it looks frankly ridiculous bulging over the top of the tight waistband. However even this pales into comparison to the nauseating sight of seeing another man’s “package” prominently and conspicuously displayed. At least Linford could get away with it, but this guy looks like he’s doing it for a bet. Why he couldn’t have simply put a pair of shorts on over the top for everyone’s benefit is beyond me.

I know the internet caters for virtually every eventuality and there is a site to suit all, but I didn’t think it would go this far! No pop culture reference this time as I couldn’t think of one. Perhaps one of the more resourceful amongst you could come to my rescue.

As the summer ends the temperature inevitably drops. Now you may be wondering why I am stating the obvious, but it is very relevant to the cyclist. Especially those who have to get up at sparrow and brave the briskness of the pre-dawn chill. Now, being full of English blood you might expect greater tolerance to the cold, but there is something unique about the Adelaide winter. The cold just seems to go through you in a way I don’t remember back in Blighty, perhaps due to never being in it long enough to notice.

But rather than admit defeat, as one of my colleagues has, I have taken steps to make sure I can still brave the elements. Admittedly this colleague hails from Singapore, so can be forgiven for not wanting to go out when the air temperature is in single digits, but I’m not willing to give up that easily. This must be a commonly contested problem for cyclists as the local bike shops are out-doing themselves with protection. Despite the preponderance of lycra I have opted for some simple yet effective solutions. Gloves are a given, but the important aspect is to ensure they are windproof as windchill-induced frostbite makes applying brakes difficult.

My other new purchase is a balaklava. With only eye-holes my face and ears stay cold. The downside is that I resemble a member of the IRA – if they took up cycling – and moved to Australia. Oh well.